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KMID : 0385920120230030394
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Journal of the Korean Society of Emergency Medicine
2012 Volume.23 No. 3 p.394 ~ p.399
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Clinical Manifestations of Heat Stroke that Occur during a Marathon
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Ma Bum-Sug
Wee Jung-Hee
Youn Chun-Song
Kim Soo-Hyun
Park Jeoung-Ho
Park Kyu-Nam
Choi Seung-Phill
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Abstract
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Purpose: Due to an increased interest in health, there have been many types of marathon races for athletes and the general population. Marathon is an extremely difficult sport, therefore, many running injuries can occur. In this study, we aimed at characterization of injuries and clinical courses resulting from marathon induced heat stroke. Based on our
findings, we provide suggestions for proper management of patients with marathon induced heat stroke.
Methods: We performed a retrospective study of 24 patients who visited the emergency department (ED) at
Yeouido St. Mary’s hospital between January 2000 and August 2011 with symptoms of heat stroke resulting from
participation in a marathon race. We reviewed the medical records, which showed clinical presentation and laboratory
findings.
Results: Of the 24 patients, 20(83.3%) were men. Their average age was 38.1±8.4 years old and their average initial rectal temperature was 39.9±1.3?C. Seventeen (70.8%) patients came to the ED complaining of syncope and seven(29.2%) came because of mental change. In follow-up laboratory tests, ten patients showed an increased level of serum Creatine phosphokinase (CPK) to over 1,000 IU/L, six showed serum Aspartate aminotransferase (AST)/Alanine aminotransferase (ALT) to over 300 IU/L, four showed serum creatinine to over 2.0 mg/dL, and two showed an increase in serum troponin-I and MB fraction of creatine kinase. Results of initial laboratory tests showed normal AST/ALT levels, however, they started to rise between 12 to 24 hours, and reached the highest record after 2~3 days of hospitalization.
Conclusion: Marathon induced heat stroke can cause various complications, such as rhabdomyolysis, acute hepatic injury, acute renal failure, and metabolic acidosis. Therefore, we recommend follow-up and observation for
patients with marathon induced heat stroke.
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KEYWORD
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Heat stroke, Marathon, Clinical manifestations
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